Insurance Denied For Man Living With Crohn’s Disease: Terry’s Story
Terry, aged 41, suffers from Crohn’s disease. Although he was able to work for many years, his condition worsened and he couldn’t handle his position while trying to manage his disease anymore. After his insurance claim was denied, he came to Share Lawyers for help.
Diagnosed With Crohn's
Terry was diagnosed with Crohn’s disease in his mid-20s after noticing severe digestive issues - namely weight loss and mouth sores. Through the advice of his doctor, he was able to manage his condition with nutrition and anti-inflammatory medications for many years without it interfering too much with his daily life and work.
Terry always loved computers and worked in tech support for a large media company in Toronto. There were some days where Terry felt better than others, but he tended not to complain and could work with few issues.
Began To Experience More Intense Flare Ups
In December 2016, he began to experience more intense flare ups with his symptoms. He was using the bathroom so many times during the day and feeling constant discomfort. This was frustrating and often embarrassing for him. His anxieties about his digestive distress seemed to worsen the condition for him and his mouth sores made it difficult to eat.
Terry’s co-workers noticed his weight loss and his general fatigue. Although their inquiries about his well-being were well-intentioned, it made him more self-conscious. He became inefficient with his work and had a difficult time coping.
Terry Applied For Short-Term Disability
He decided to go on short-term disability to gather his strength. Who knew, maybe the stress of working in these conditions was making his symptoms worse?
Terry decided to the take initiative. He became stricter about his diet and practised meditation and stretching to manage his anxiety. However, his claim was denied by the plan administrator. He then applied for E.I.-disability, which he received for 15 weeks.
After that time, he was not feeling any better and missed a trip to the West Coast with his wife to visit his daughter in university over the winter break. Feeling totally depleted and in constant pain, he applied for long-term disability through his insurance company.
Insurance Company Denied His Claim
The response from his insurance company was sceptical - they did not believe that Terry’s Crohn’s symptoms were disabling as he had coped with them for more than twenty years. They cited insufficient medical evidence and denied his claim. How could this be? Terry couldn’t understand why they wouldn’t believe the fact that his symptoms had worsened. He returned to a specialist and tried to appeal twice on his own, but to no avail. He was exhausted and had been so sick for so long. Terry felt ready to give up. But how was he going to support his family? The question kept him up at night.
Share Lawyers Negotiated A Settlement
Terry was watching TV when he saw an ad for Share Lawyers. He decided to try their services and see if anything could be done. Share Lawyers immediately began helping Terry by arranging a referral for him to see a gastroenterologist for a more comprehensive workup and assessment to substantiate the claims for the insurance company. The insurance company hit back hard, but Share Lawyers were in Terry’s corner and weren’t backing down. Share Lawyers worked to negotiate a settlement for all the back payments owed to Terry from when he stopped working and for future payments moving forward.
Terry’s not ready to go back to his job, but he has peace of mind without the added stress of feeling helpless, Terry is moving forward to work on his well- being. One of his doctors have suggested surgery if his symptoms do not start improving.
Share Lawyers is proud to have helped Terry through this stressful time in his life, and letting him know that he was not alone in his fight with the insurance company.
*All names and identifying details have been changed to protect the confidentiality of all involved.
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A note from our long term disability lawyers
Taking a medical leave from work is not an easy decision to make. Concerns about providing for yourself and your family and keeping your job may cause you to want to push through your pain, but this won’t make your problems go away. Stopping work is often the smartest decision for your long term health and well-being, and your disability benefits are there to provide you with financial support until you can return to work.
If you have made the tough decision to stop working and apply for your short term disability or long term disability benefits, you may feel overwhelmed by the process and have questions that your employer and your insurance company are not able or willing to answer. Share is There to see you through and answer your questions.
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We understand that things have not been easy for you over the last little while. Your health has been suffering, you are unable to work, and now your insurance company, who was supposed to be there in your time of need, has decided they will not pay your disability benefits or respect your disability claim. These benefits exist to provide you with the financial support you need so that you can focus on your health and rebuilding your life. It is unfortunate that your insurance company has not lived up to its promise. If your disability claim has been denied, we will fight to get you the benefits you are entitled to. Our disability lawyers have helped thousands of Canadians get their long term disability benefits over the past 35 years, and we can help you too.
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Share Lawyers believes that every client who is dealing with a disability claim deserves superior personal service. To achieve that goal, we have developed our team of experienced, compassionate, and caring long term disability lawyers, law clerks, and administrative staff to meet all of your needs. Our team of experienced long term disability, life insurance, employment, and critical illness insurance lawyers have made successful claims against many insurance companies, third-party administrators and employers.
If you are unable to work, your disability benefits should be there to provide you with the financial support you need. While your insurance company may be focused on finding ways to avoid paying your claim, our focus is on what is in your best interest. When Share Lawyers gets involved, you have an entire team of lawyers that are there to support you and to fight for what is yours.
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In this video, we explain the role of a long term disability lawyer and how we can support you when you have been denied your long term disability benefits.